<div class="row-fluid">
    <div class="span12">
        <div class="grid simple">
            <div class="grid-title no-border">
                <br />
            </div>
            <div class="grid-body no-border">
                <form method="post">
                    <input type="text" value="67" name="currency" /><br />
                    <input type="submit" value="Save" class="btn btn-primary btn-large" />
                </form>                
            </div>
        </div>	
    </div>
</div>